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pISSN 2950-9114 eISSN 2950-9122
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Original Article

Lab Med Qual Assur 2021; 43(3): 143-151

Published online September 30, 2021


Copyright © Korean Association of External Quality Assessment Service.

Impact of Whole Blood Storage Conditions in Flow Cytometric Analysis for Paroxysmal Nocturnal Hemoglobinuria

Sewon Yoon , Jimyung Kim , Seon Young Kim , Jinsook Lim , Gye Cheol Kwon , and Sun Hoe Koo

Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea

Correspondence to:Jimyung Kim
Department of Laboratory Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea
Tel +82-42-280-7998
E-mail jmkim@cnuh.co.kr

Received: February 10, 2021; Revised: April 12, 2021; Accepted: April 26, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: We evaluated the effect of four blood storage conditions (refrigeration, fixation [with the Cyto-Chex and TransFix tubes], and physiologic stabilization using Ficoll polymer PM70) for 72 hours in flow cytometric analysis of paroxysmal nocturnal hemoglobinuria (PNH).
Methods: Peripheral whole blood (WB) was collected in Cyto-Chex tubes (Streck, USA), TransFix tubes (Cytomark, UK) and ethylenediaminetetraacetic acid (EDTA) tubes (Becton Dickinson, USA) from 20 patients with a PNH clone (≥1.0%) and 15 controls. PM70 (10%; GE Healthcare, USA)-EDTA WB was prepared. Samples were stored at room temperature (RT) or 4°C for 72 hours. Flow cytometric analysis was performed within 4 hours and 72 hours.
Results: The percentage of PNH clones was stable in stored WB at RT without systemic error, except for those stored in EDTA WB. A substantial correlation was observed between the fresh WB and stored WB. The mean fluorescence intensity of CD235a in red blood cells (RBCs) and CD15 in neutrophils decreased in stored WB, while CD59, CD24, and fluorescent aerolysin of the PNH clone showed no significant difference. The percentage of CD15 (+) neutrophils was not different between the fresh WB and stored WB. However, the viability of granulocytes was more than 90% in the refrigerated EDTA WB.
Conclusions: Stable measurement of PNH clones in RBCs and neutrophils is possible in refrigerated the EDTA WB for up to 72 hours. In the case of storage at RT, physiological stabilization using 10% PM70 can be an alternative method for WB fixation.

Keywords: Paroxysmal hemoglobinuria, Flow cytometry, Stabilization, Fluorescence

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